world cancer report - iarc

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Drug or drug combination Cancer IARC Group 2A Androgenic (anabolic) steroids Liver cancer Bis(chloroethyl) nitrosourea (BCNU) Leukaemia Chloramphenicol Leukaemia 1-(2-Chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) Leukaemia Etoposide Leukaemia 5-Methoxypsoralen Skin cancer Nitrogen mustard Skin cancer Procarbazine hydrochloride Leukaemia Teniposide Leukaemia Table 2.14 Medicinal drugs that are probably carcinogenic to humans (IARC Group 2A). REFERENCES 1. Selbey JV, Friedman GD, Herrinton LJ (1996) Pharmaceuticals other than hormones. In: Schottenfeld D, Fraumeni, JF eds, Cancer Epidemiology and Prevention, New York, Oxford University Press, 489-501. 2. Bernstein JF, Henderson BE (1996) Exogenous hormones. In: Schottenfeld D, Fraumeni, JF eds, Cancer Epidemiology and Prevention, New York, Oxford University Press, 462-488. 3. IARC (1998) Hormonal Contraception and Post- Menopausal Hormonal Therapy (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 72), Lyon, IARCPress. 4. IARC (1996) Some Pharmaceutical Drugs (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 66), Lyon, IARCPress. 50 The causes of cancer 5. White IN (2001) Anti-oestrogenic drugs and endometrial cancers. Toxicol Lett, 120: 21-29. 6. IARC (2000) Some Antiviral and Antineoplastic Drugs and Other Pharmaceutical Agents (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 76), Lyon, IARCPress. 7. IARC (1999) Surgical Implants and Other Foreign Bodies (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 74), Lyon, IARCPress. The recent past has not been marked by major discoveries in relation to cancer causation by drugs. This situation is attributable, at least in part, to the vigilance imposed by national authorities in relation to preclinical and clinical drug testing. Putative drugs exhibiting activity in relevant carcinogen-screening tests are unlikely to be carried forward to final development and marketing. Consequently, the prevention of cancer attributable to medical treatment is not identified as a major public health need. WEBSITE IARC Monographs programme, online search facility: http://monographs.iarc.fr
RADIATION SUMMARY > Exposure to ionizing radiation from natural as well as from industrial, medical and other sources, can cause a variety of neoplasms, including leukaemia, breast cancer and thyroid cancer. > Sunlight is by far the most significant source of ultraviolet irradiation and causes several types of skin cancer, particularly in highly-exposed populations with fair skin, e.g. Australians of Caucasian origin. > Extremely low frequency electromagnetic fields generated by electrical power transmission have been associated with an increased risk of childhood leukaemia, but the findings are not conclusive. Natural and man-made sources generate radiant energy in the form of electromagnetic waves. Their interaction with biological systems is principally understood at the cellular level. Electromagnetic waves are characterized by their wavelength, frequency, or energy. Effects on biological systems are determined by the intensity of the radiation, the energy in each photon and the amount of energy absorbed by the exposed tissue. The electromagnetic spectrum extends from waves at low frequency (low energy), referred to as “electric and magnetic fields”, to those at very high frequencies, which are often called “electromagnetic radiation” (Fig. 2.38). The highest-energy electromagnetic radiation is X- and γ-radiation, which have sufficient photon energy to produce ionization (i.e. create positive and negative electrically-charged atoms or parts of molecules) and thereby break chemical bonds. Other forms of ionizing radiation are the sub-atomic particles (neutrons, electrons (β-particles) and α− particles) that make up cosmic rays and are also emitted by radioactive atoms. Non-ionizing radiation is a general term for that part of the electromagnetic spectrum which has photon energies too weak to break chemical bonds, and includes ultraviolet radiation, visible light, infrared radiation, radiofrequency and microwave fields, extremely low frequency (ELF) fields, as well as static electric and magnetic fields. Ionizing radiation Exposure to ionizing radiation is unavoidable [1]. Humans are exposed both to Xrays and γ−rays from natural sources (including cosmic radiation and radioactivity present in rocks and soil) and, typically to a much lower extent, from man-made sources (Fig. 2.35). On average, for a member of the general public, the greatest contribution comes from medical X-rays and the use of radiopharmaceuticals, with lower doses from fallout from weapons testing, nuclear accidents (such as Chernobyl), and accidental and routine releases from nuclear installations. Medical exposures occur both in the diagnosis (e.g. radiography) of diseases and injuries and in the treatment (e.g. radiotherapy) of cancer and of some benign diseases. Occupational exposure to ionizing radiation occurs in a number of jobs, including the nuclear industry and medicine. Airline pilots and crew are exposed to cosmic radiation. Cancer causation Ionizing radiation is one of the most intensely studied carcinogens [2-4]. Fig. 2.34 Modern diagnostic radiology is no longer a significant source of exposure to ionizing radiation. Fig. 2.35 Estimated annual dose of ionizing radiation received by a member of the general public. Radiation 51
Page 2 and 3: WORLD HEALTH ORGANIZATION WHO OMS I
Page 4 and 5: WORLD CANCER REPORT Editors Bernard
Page 6 and 7: CONTENTS Foreword 9 1 The global bu
Page 8 and 9: The global burden of cancer Cancer
Page 10 and 11: Fig. 1.2 Incidence and mortality of
Page 12 and 13: Central and Southern Europe differ
Page 14 and 15: Incidence of cancer in South Centra
Page 16 and 17: from documentation of disease to a
Page 18 and 19: TOBACCO SUMMARY >In addition to lun
Page 20 and 21: Fig. 2.3 Smoking by children is inc
Page 22 and 23: Cancers positively Sex Standardized
Page 24 and 25: PHARMACOLOGICAL APPROACHES TO SMOKI
Page 26 and 27: level the dose—response relations
Page 28 and 29: lipoprotein-associated cholesterol,
Page 30 and 31: Agent Cancer site/cancer Main indus
Page 32 and 33: Industry, occupation Cancer site/ca
Page 34 and 35: to occupational exposures in develo
Page 36 and 37: Air pollutant WHO Air Quality Guide
Page 38 and 39: der cancer of the order of 50% is p
Page 40 and 41: AFLATOXIN B 1 HEPATITIS VIRUS (chro
Page 42 and 43: Fig. 2.30 Correlation between regio
Page 44 and 45: MEDICINAL DRUGS SUMMARY > Certain d
Page 48 and 49: Agent or substance Cancer site/canc
Page 50 and 51: sources of electromagnetic fields [
Page 52 and 53: CHRONIC INFECTIONS SUMMARY > Infect
Page 54 and 55: Infection Subclinical Mutagenic fac
Page 56 and 57: TUMOURS ASSOCIATED WITH HIV/AIDS Ap
Page 58 and 59: DIET AND NUTRITION SUMMARY > Up to
Page 60 and 61: Fig. 2.54 The age-adjusted mortalit
Page 62 and 63: OVERWEIGHT, OBESITY AND PHYSICAL AC
Page 64 and 65: IMMUNOSUPPRESSION SUMMARY >Persiste
Page 66 and 67: Fig. 2.64 Cancer following immunosu
Page 68 and 69: Syndrome Gene Location Cancer site/
Page 70 and 71: viduals, confirmation of a gene def
Page 72 and 73: REPRODUCTIVE FACTORS AND HORMONES S
Page 74 and 75: PHYTO-ESTROGENS AND CANCER PEVENTIO
Page 76 and 77: Indicator Number of oral contracept
Page 79 and 80: Mechanisms of tumour development Th
Page 81 and 82: The stages in tumorigenesis have be
Page 83 and 84: PRECURSOR LESIONS IN CHEMOPREVENTIO
Page 85 and 86: CARCINOGEN ACTIVATION AND DNA REPAI
Page 87 and 88: adducts, a few weeks or months for
Page 89 and 90: I Reactive oxygen species Methylati
Page 91 and 92: which remove the mismatched bases,
Page 93 and 94: Common human oncogenes Many common
Page 95 and 96: product of the RB1 gene (pRb) and a
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ates a molecular bridge between p53
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potential cancer genes altered thro
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One of the earliest genes to be ide
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Regulation of the cell cycle and co
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CELL-CELL COMMUNICATION SUMMARY > C
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Connexin genes and tumour suppressi
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APOPTOSIS SUMMARY > The term apopto
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Caspase-8 Caspase-3 c-FLIP Procaspa
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ways. Several options are under inv
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INVASION AND METASTASIS SUMMARY > T
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laminin, entactin and also heparan
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Target Example of agent Comments Ad
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organs, and to respond to local gro
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TOBACCO CONTROL SUMMARY > Tobacco-i
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Region Deaths due to % of total dea
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ipated, is primarily attributable t
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smoke. This may be achieved in part
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there is no evidence for the effica
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industries, processes and occupatio
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stoves arises in rural areas of dev
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Climbing plants on trellis at end r
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HEPATITIS B VACCINATION SUMMARY > P
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Fig. 4.17 Chronic active HBV-associ
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HUMAN PAPILLOMAVIRUS VACCINATION SU
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Vaccine Site of trial Number of pat
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prolonged use. Similar drugs, that
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aspirin and other non-steroidal ant
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SCREENING FOR BREAST CANCER SUMMARY
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Fig. 4.35 Cumulative mortality from
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SCREENING FOR PROSTATE CANCER SUMMA
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Fig. 4.39 Poster designed for an an
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is around 10% for cancer (out of ev
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45 with one positive rehydrated FOB
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eing based on (i) time trends in th
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Fig. 4.48 Women at a clinic in Indi
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SCREENING FOR ORAL CANCER SUMMARY >
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India will provide useful informati
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cer incidence following cure of inf
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100 50 25 10 5 2.5 1 Japan Males Fe
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Human cancers by organ site Maligna
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tobacco smoking: age at start, aver
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diagnosis is usually confirmed by h
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is frequent and survival rates are
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Fig. 5.14 Physician reading digital
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Markers of prognosis in breast canc
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cer in the contralateral breast (Ch
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100 50 25 10 5 2.5 1 Japan Chile Po
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depends on staging. Small intramuco
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Fig. 5.30 A diet rich in fresh frui
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ane protein involved in cell adhesi
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LIVER CANCER SUMMARY > About 560,00
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Fig. 5.39 A woman in the Gambia pre
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REFERENCES 1. Ferlay J, Bray F, Par
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Certain Possible Uncertain Age Andr
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Management The dramatic division be
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TUMOUR NORMAL Gastrula PGC 2n Impri
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CANCERS OF THE FEMALE REPRODUCTIVE
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Fig. 5.62 Five-year relative surviv
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Inheritance of high-penetrance gene
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invasive malignant. Malignant germ
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OESOPHAGEAL CANCER SUMMARY >Cancer
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Fig. 5.76 A radiographic view of an
Page 221 and 222:
with a stent; laser recannulation,
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Fig. 5.82 Risk of bladder cancer am
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Partial cystectomy is appropriate f
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poorly known since hypopharyngeal c
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Fig. 5.92 Oral leukoplakia with mil
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LYMPHOMA SUMMARY > Malignant lympho
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T Fig. 5.101 Nuclear magnetic reson
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Fig. 5.106 Five-year relative survi
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Fig. 5.109 The immediate aftermath
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A B Fig. 5.113 Acute myeloid leukae
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Fig. 5.118 Five-year relative survi
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Fig. 5.120 Age-specific incidence a
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Hereditary condition Mode of inheri
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MELANOMA SUMMARY > Approximately 13
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Fig. 5.131 Primary melanoma with a
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THYROID CANCER SUMMARY > Cancer of
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Papillary carcinoma RET/PTC TRK BRA
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KIDNEY CANCER SUMMARY > Cancer of t
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Stage Clear cell carcinoma Papillar
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TUMOURS OF THE NERVOUS SYSTEM SUMMA
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ing the optic tract, brain stem and
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mut = mutant p53 wt = wildtype p53
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SURGICAL ONCOLOGY SUMMARY > Surgica
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Year Radical mastectomy (%) Modifie
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TELEMEDICINE The prospects for tele
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Equipment Energy 50% depth dose App
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CANCER EDUCATION IN MEDICAL COURSES
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Fig. 6.10 Crystals of cisplatin: mo
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Responsiveness Cancer (in decreasin
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Most of the world’s most common c
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treatment of cancer. The problems l
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duction. It is clear that tumour ce
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REHABILITATION SUMMARY > Rehabilita
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cer and its associated disability.
Page 289 and 290:
REFERENCES 1. Garden FH, Gillis TA
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Cancer pain relief varies and in so
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EMERGING ISSUES IN PALLIATIVE CARE
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Cancer control The negative impact
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priority to cancer control activiti
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Prevention of cancer Every country
Page 301 and 302:
- Assessing the magnitude of the ca
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high-risk women. Further details on
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ecords departments are either rudim
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THE INTERNATIONAL AGENCY FOR RESEAR
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in the capitals/urban areas of four
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in the overall cancer strategy. WHO
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68% 1955 1975 1995 2025 32% 40% by
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Fig. 7.15 A grandfather at work in
Page 317 and 318:
Fig. 7.17 Main causes of death in d
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Contributors and Reviewers Sources
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Dr Vera Luiz da Costa e Silva Tobac
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Georgia Moore Centers for Disease C
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REVIEWERS Dr Sandra E. Brooks 405 W
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2.53 T. Norat and E. Riboli, IARC 2
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Gastroenterology, 118(2 Suppl 1): S
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5.106 & 5.107 IARC/SEER/Osaka Cance
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4.17 R. Lambert, IARC/Adapted from
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Brain cancer, see nervous system tu
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Fibroblast growth factor (FGF), 117
Page 339 and 340:
Microarray, 240 Micronutrients, 65,
Page 341 and 342:
S Saccharin, 64, 85 Salicin, 153 Sa
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